MedicaidBilling CodesMedium impact
BT202065: Participant-directed attendant care and home care services available for A&D Waiver July 1, 2020
Indiana Medicaid (IHCP)·IN·Specialty Services
Effective date
Jul 1, 2020
We identified it
Jun 19, 2026
Summary
Indiana Medicaid is launching a pilot program for two new participant-directed care services under the A&D Waiver starting July 1, 2020. Both services use the same billing code S5125 with specific modifier combinations and require prior authorization through care managers.
Action Required
By July 1, 2020: Billing team must add new HCPCS code S5125 with modifier combinations (U7+U2+UA for PDAC, U7+U2+U9 for PDHCS) to billing system for Indiana Medicaid A&D Waiver members. Update prior authorization workflow to obtain approval through Care Management for Social Services (CaMSS) system before providing services. Verify Notice of Action (NOA) is received before billing. Services are billed per 15-minute increments and limited to pilot program geographical area.